谷氨酰胺对老年胃肠手术后患者肠粘膜通透性和临床预后的影响

Impact of Glutamine of Gut Permeability and Clinical Prognosis on the AgingPatients Undergoing Gastric- intestinal Operation

目的 评价谷氨酰胺对老年胃肠术后患者肠粘膜通透性和预后的影响。方法 30例 60岁以上接受胃肠手术患者，采用随机双盲的设计，给予等氮等热卡的肠外营养，研究组添加丙氨酰－谷氨酰胺双肽 [0.50 g/(kg· d） ]。对血浆氨基酸谱、肠粘膜通透性、临床预后和氮平衡进行观察，并检查血生化指标和观察不良反应以了解安全性。结果 术前两组患者具有可比性。研究组血浆谷氨酰胺水平高于对照组， L/M比值低于对照组，其累计 6 d氮平衡明显优于对照组。与感染有关的并发症对照组较多，两组患者均未发现任何不良反应。结论 添加谷氨酰胺的肠外营养可以维持肠粘膜通透性，进一步改善氮平衡，减少并发症。

Objective To evaluate the impact of parenteral nutrition supplemented glutamine on aging patients undergoing gastric-intestinal operation. Methods 30 patients above 60 years old undergoing gastric-intestinal operation, a randomized double-blind protocol was designed, divided into two groups, received impact isocaloric parenteral nutrition. The study group received alanyl-glutamine [0.5g/(kg· d) ]. To observe plasma amino acids profile, nitrogen balance, intestinal permeability and clinical prognosis, examine clinical chemistry variables and observe the adverse reactions in order to find out its safety. Results The patients in both groups were comparable prior to the operation. The plasma glutamine level of study group is higher than the control group, it's cumulative nitrogen balance values were prior to the control group, L/M ratio was lower than the control group. The complications related to infection was observed more in the control group. No adverse reaction was observed in both groups. Conclusions Ala-Gln-supplemented PN improved nitrogen balance and maintained intestinal permeability , reduced complications.